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1
00:00:21,080 --> 00:00:23,800
ุจุณู… ุงู„ู„ู‡ ุงู„ุฑุญู…ู† ุงู„ุฑุญูŠู…ุŒ ุงู„ุณู„ุงู… ุนู„ูŠูƒู… ูˆุฑุญู…ุฉ ุงู„ู„ู‡

2
00:00:23,800 --> 00:00:29,660
ูˆุจุฑูƒุงุชู‡ ูˆู…ุฑุญุจุงู‹ ุจูƒู… ุฌู…ูŠุนู‹ุง. ุณู†ุชู†ุงูˆู„ ุงู„ูŠูˆู… ู…ูˆุถูˆุน

3
00:00:29,660 --> 00:00:39,960
ุนู„ุงู…ุงุช ุชู‚ู„ูŠู„ ุงู„ู‡ูŠุจูˆูƒุณูŠุง 

4
00:00:39,960 --> 00:00:45,550
ูˆุงู„ู‡ุงูŠุจุฑูƒุงุจู†ูŠุง. ููŠ ุงู„ู…ุญุงุถุฑุฉ ุงู„ุณุงุจู‚ุฉ ุนุฑูู†ุง ุงู„ู€

5
00:00:45,550 --> 00:00:50,270
hypoxia ู†ู‚ุต ููŠ ุงู„ุฃูƒุณุฌูŠู† ุงู„ุฏุงุฎู„ ู„ู€ anterior

6
00:00:50,270 --> 00:00:56,010
surface of the corneaุŒ ูˆุงู„ู€ hypercapnia ุฒูŠุงุฏุฉ ููŠ

7
00:00:56,010 --> 00:00:59,910
ุซุงู†ูŠ ุฃูƒุณูŠุฏ ุงู„ูƒุฑุจูˆู† ุงู„ุฐูŠ ุฏุงุฎู„ ู„ู€ anterior surface

8
00:00:59,910 --> 00:01:05,670
of the cornea. ู…ู† ู‡ุฐู‡ ุงู„ุนู„ุงู…ุงุช ุทุจุนู‹ุง ู‡ูŠ ู…ุชุนู„ู‚ุฉ ูƒู„ู‡ุง 

9
00:01:05,670 --> 00:01:11,540
ููŠ ุงู„ู€ corneal epitheliumุŒ superficial punctate

10
00:01:11,540 --> 00:01:16,460
keratitisุŒ superficial ุณุทุญูŠ punctate ู†ู‚ุทุฉ

11
00:01:16,460 --> 00:01:19,980
keratitisุŒ inflammation of the cornea.

12
00:01:22,870 --> 00:01:27,270
ุทุจุนู‹ุง ูŠูƒูˆู† ุนู†ุฏู…ุง ู†ู‚ูˆู… ุจุนู…ู„ corneal fluorescein staining

13
00:01:27,270 --> 00:01:31,570
ุนู†ุฏ ุฅุฌุฑุงุก ุงู„ corneal fluorescein staining ู†ู„ุงุญุธ ุฃู†

14
00:01:31,570 --> 00:01:37,050
ุณุทุญ ุงู„ู‚ุฑู†ูŠุฉ ูŠุธู‡ุฑ ุจุงู„ุดูƒู„ ู‡ุฐุง ูˆูƒุฃู†ู‡ ู†ู‚ุงุท ุนู„ู‰ ุงู„

15
00:01:37,050 --> 00:01:41,500
corneal epithelium. ููŠ ุงู„ู…ุนู…ู„ ุฃุฎุฐู†ุง ุงู„ corneal

16
00:01:41,500 --> 00:01:46,620
staining ูˆู‚ุณู…ู†ุงู‡ุง ุฅู„ู‰ grade 0 ูˆ 1 ูˆ 2 ูˆ 3 ูˆุนุฑูู†ุง

17
00:01:46,620 --> 00:01:51,540
ุฃู† grade 0 no staining of the corneaุŒ grade 1 mild

18
00:01:51,540 --> 00:01:54,660
staining of the corneal epitheliumุŒ grade 2

19
00:01:54,660 --> 00:01:57,940
moderate staining of the corneal epitheliumุŒ ูˆ

20
00:01:57,940 --> 00:02:03,660
grade 3 severe staining of the corneal epithelium. 

21
00:02:03,660 --> 00:02:08,340
A premature shedding of small groups of surface

22
00:02:08,340 --> 00:02:15,300
cellsุŒ ุงู„ุทุจู‚ุฉ ุฃูˆ ุงู„ู€ corneal epithelium ุนู†ุฏ ุงุฑุชุฏุงุก

23
00:02:15,300 --> 00:02:19,500
ุงู„ุนุฏุณุฉ ุงู„ู„ุงุตู‚ุฉ ุณุชุชู‚ุดุฑุŒ ุฅุฐุง ุณูŠุญุฏุซ ู„ู‡ุง ู†ูˆุน ู…ู† 

24
00:02:19,500 --> 00:02:25,160
ุงู„ุชู‚ุดุฑุŒ ุจุงู„ุชุงู„ูŠ ุฃู† ู‡ูŠ ุณูŠุญุฏุซ ููŠู‡ุง ุถุนูุŒ ู†ุชูŠุฌุฉ ู…ุงุฐุง 

25
00:02:25,160 --> 00:02:32,200
ู‡ุฐุง ุงู„ุชู‚ุดุฑุŸ ุถุนู ุงู„ุฑูˆุงุจุท ู…ุง ุจูŠู† ุงู„ุฎู„ุงูŠุง. ุฃูƒุซุฑ ุดูŠุก

26
00:02:32,200 --> 00:02:36,680
ู†ุฎุงู ู…ู†ู‡ ููŠ ู‡ุฐุง ุงู„ู†ูˆุน ู‡ูˆ ู…ูˆุถูˆุน ุงู„ infectionุŒ

27
00:02:36,680 --> 00:02:40,720
ุงู„ุนุฏูˆู‰ุŒ ู„ู…ุงุฐุงุŸ ู„ุฃู† ุทุจู‚ุฉ ุงู„ corneal epithelium ู‡ูŠ

28
00:02:40,720 --> 00:02:45,620
ุชุนุชุจุฑ regenerationุŒ ูŠุนู†ูŠ ุญุชู‰ ู„ูˆ ุชู‚ุดุฑุช ุจุนุฏ 24 ุณุงุนุฉ

29
00:02:45,620 --> 00:02:50,880
ุณูŠุญุฏุซ ุนู…ู„ูŠุฉ ู…ุงุฐุงุŸ ุชุฌุฏุฏ ู„ู‡ุงุŒ ูˆู„ูƒู† ุงู„ุฎูˆู ู…ู† ุงู„

30
00:02:50,880 --> 00:02:54,100
superficial punctate keratitis ู‡ูˆ ู…ูˆุถูˆุน ุงู„

31
00:02:54,100 --> 00:02:54,520
infection.

32
00:02:57,860 --> 00:03:02,140
ุจุนุฏ ุฐู„ูƒ ู…ุงุฐุง ุณูŠุณุจุจุŸ ุฅุฐุง ุฃูˆู„ ุดูŠุก ุณูŠุญุฏุซ ุชู‚ุดุฑ ู„ู„ู€

33
00:03:02,140 --> 00:03:05,760
corneal epitheliumุŒ number two disruption of the

34
00:03:05,760 --> 00:03:11,640
ocular surface mucous layerุŒ ุฃูŠ ุจู…ุนู†ู‰ ุนุฑู‚ู„ุฉ ุฃูˆ ู‚ุทุน

35
00:03:11,640 --> 00:03:16,940
ู„ู…ูŠู†ุŸ ู„ู„ุทุจู‚ุฉ ุงู„ู…ุฎุงุทูŠุฉ ุงู„ุชูŠ ู…ูˆุฌูˆุฏุฉ ุฃูŠู†ุŸ ููŠ ุณุทุญ

36
00:03:16,940 --> 00:03:17,480
ุงู„ุนูŠู†.

37
00:03:20,470 --> 00:03:25,530
ุชุชู…ูŠุฒ ุงู„ superficial punctate keratitis ุจุฃู†ู‡ุง

38
00:03:25,530 --> 00:03:31,060
asymptomaticุŒ ู…ุงุฐุง ูŠุนู†ูŠ ุฐู„ูƒุŸ ูŠุนู†ูŠ ู„ุง ูŠูˆุฌุฏ ู‡ู†ุงูƒ ุฃุนุฑุงุถุŒ

39
00:03:31,060 --> 00:03:35,840
ูŠุนู†ูŠ ุงู„ู…ุฑูŠุถ ู„ุง ูŠุดุนุฑ ุจุฃูŠ ุฃู„ู…ุŒ ู„ุง ูŠูˆุฌุฏ ุฃู„ู… ูŠุดุนุฑ ุจู‡

40
00:03:35,840 --> 00:03:39,280
ู…ู† ุงู„ู…ุฑูŠุถุŒ ูŠุนู†ูŠ ู„ู† ูŠุฃุชูŠ ุนู„ู‰ ุงู„ู…ุฑูƒุฒ ูˆูŠู‚ูˆู„ ู„ูŠ ู…ุซู„ู‹ุง

41
00:03:39,280 --> 00:03:42,500
ููŠ ุนู†ุฏูŠ watering ุฃูˆ ููŠ ุนู†ุฏูŠ redness ุฃูˆ ููŠ ุนู†ุฏูŠ

42
00:03:42,500 --> 00:03:46,740
itchingุŒ ู„ุง without painุŒ ูƒูŠู ุฃุจุฏุฃ ุจุงูƒุชุดุงูู‡ุงุŸ ู…ู†

43
00:03:46,740 --> 00:03:50,040
ุงู„ clinical sign of a dry eyeุŒ ุนุจุงุฑุฉ ุนู† ุงู„

44
00:03:50,040 --> 00:03:55,100
corneal fluorescein staining. Asymptomatic because

45
00:03:55,100 --> 00:04:00,080
the injury threshold of the cornea is less than

46
00:04:00,080 --> 00:04:05,160
the touch threshold. ุฏุงุฆู…ู‹ุง ูƒู„ู…ุฉ threshold ู…ุนู†ุงู‡ุง

47
00:04:05,160 --> 00:04:11,260
ุงุณุชุทุงู„ุฉ ุฃูˆ ุฅุซุงุฑุฉุŒ ุฏุงุฆู…ู‹ุง ุนู†ุฏู…ุง ูŠูƒูˆู† ุงู„ุงุณุชุทุงู„ุฉ ุฃูˆ

48
00:04:11,260 --> 00:04:16,100
ุงู„ุฅุซุงุฑุฉ ููŠ ุงู„ุฃุทุฑุงู ูŠูƒูˆู† ุฃู‚ู„ ุชุฃุซูŠุฑู‹ุง ู…ู† ุนู†ุฏู…ุง ุชูƒูˆู† ููŠ

49
00:04:16,100 --> 00:04:20,920
ุงู„ู€ centerุŒ ูู„ุฐู„ูƒ ุงู„ู…ุฑูŠุถ ู„ุง ูŠุดุนุฑ ุจุฃูŠ ูˆุฌูˆุฏ ู„ู„ุฃู„ู….

50
00:04:33,860 --> 00:04:39,820
ู…ู„ุงุญุธูŠู† ููŠ ุงู„ุดูƒู„ ุฃู† ูˆุฌูˆุฏ ุงู„ staining ุฃูŠู†ุŸ ุนู„ู‰ ุงู„

51
00:04:39,820 --> 00:04:45,740
upper partุŒ ุฃูŠุถู‹ุง ู„ู„ corneal epitheliumุŒ staining in a 

52
00:04:45,740 --> 00:04:47,660
horizontal linear pattern.

53
00:04:51,550 --> 00:04:55,630
close to the superior limbusุŒ ุณูŠูƒูˆู† ู‚ุฑูŠุจ ู…ู† ู…ู†

54
00:04:55,630 --> 00:04:59,110
ุงู„ู€ limbusุŒ ู„ุฃู†ู‡ ู†ุนุฑู ุฃู† ุงู„ diameter ู„ู„ุนุฏุณุฉ

55
00:04:59,110 --> 00:05:03,890
ุงู„ู„ุงุตู‚ุฉ ุงู„ู€ soft contact lenses ุณุชุตู„ ุชู‚ุฑูŠุจู‹ุง ู„ู„ para

56
00:05:03,890 --> 00:05:11,330
limbal. OkayุŒ the sign is more likely in patients

57
00:05:11,330 --> 00:05:16,290
with tight or low positioning upper lids. ุฏุงุฆู…ู‹ุง 

58
00:05:16,290 --> 00:05:19,950
ู‡ุฐู‡ ุชูƒูˆู† ู…ุตุงุญุจุฉ ู„ู…ู†ุŸ ู„ุฅู†ุณุงู† ุนู†ุฏู‡ tight

59
00:05:23,140 --> 00:05:31,440
ู„ู„ upper eyelid. ู‡ุฐู‡ ุงู„ู†ู‚ุทุฉ ุงู„ุฃูˆู„ู‰ุŒ ุงู„ู†ู‚ุทุฉ ุงู„ุซุงู†ูŠุฉ 

60
00:05:31,440 --> 00:05:42,420
ุฃู† ู‡ุฐุง ุงู„ุดุฎุต ู…ุงุฐุง ูŠูƒูˆู† ุนู†ุฏู‡ุŸ partially tosesุŒ ุจู…ุนู†ู‰

61
00:05:42,420 --> 00:05:46,900
ุฃู† ู„ุง ูŠุญุฏุซ ู‡ู†ุงูƒ ุฃูŠ ุชู‡ูˆูŠุฉ ู„ู‡ุฐู‡ ุงู„ู…ู†ุทู‚ุฉุŒ ูŠุนู†ูŠ ู„ุง

62
00:05:46,900 --> 00:05:52,340
ูŠุฏุฎู„ ุงู„ oxygen ุจูƒู…ูŠุฉ ูƒุงููŠุฉุŒ ูˆูƒุฃู†ู‡ ู‡ู†ุงูƒ close

63
00:05:53,950 --> 00:06:01,010
eyesุŒ ุฅุบู„ุงู‚ ู„ู…ู†ุŸ ู„ู„ุนูŠู†ูŠู†. Reduced

64
00:06:01,010 --> 00:06:05,750
oxygen availability to the superior region of the 

65
00:06:05,750 --> 00:06:10,630
cornea. ุฅุฐุง ุณูŠุญุฏุซ ู‡ู†ุงูƒ ู†ู‚ุต ู„ุฏุฎูˆู„ ุงู„ oxygen ููŠ ู‡ุฐู‡

66
00:06:10,630 --> 00:06:17,690
ุงู„ู…ู†ุทู‚ุฉ. Even in daily contact lens wearุŒ ุทุจุนู‹ุง hand

67
00:06:17,690 --> 00:06:21,650
daily ุฃูŠ ุจู…ุนู†ู‰ conventional daily wearุŒ ูŠุนู†ูŠ ุนุฏุณุงุช

68
00:06:21,650 --> 00:06:26,920
ุงู„ู„ุจุณ ุงู„ูŠูˆู…ูŠ ุงู„ุชู‚ู„ูŠุฏูŠ. The superior cornea is an

69
00:06:26,920 --> 00:06:31,940
extended wear is covered by the upper lid. ู…ุงุฐุง 

70
00:06:31,940 --> 00:06:37,800
ุงู„ู…ู‚ุตูˆุฏ ููŠู‡ุงุŸ ุฃู† ุงู„ู…ุฑูŠุถ ู‡ูˆ ูŠู„ุจุณ ุนุฏุณุงุช ุงู„ู„ุจุณ ุงู„ูŠูˆู…ูŠ

71
00:06:37,800 --> 00:06:41,780
ุงู„ุชู‚ู„ูŠุฏูŠุŒ ุทุจุนู‹ุง ู†ุนุฑู ุนุฏุณุงุช ุงู„ู„ุจุณ ุงู„ูŠูˆู…ูŠ

72
00:06:41,780 --> 00:06:48,410
ุงู„ุชู‚ู„ูŠุฏูŠ maximum ุณุชุตู„ ู„ู‚ุฏุงุดุŸ ุงุซู†ุชูŠ ุนุดุฑุฉ hoursุŒ ุตุญูŠุญุŸ ุงู„ุขู† 

73
00:06:48,410 --> 00:06:53,990
ู‡ุฐุง ุงู„ู…ุฑูŠุถ ู†ุชูŠุฌุฉ ุฃู† ููŠ ุนู†ุฏู‡ partially dropping ุฃูˆ

74
00:06:53,990 --> 00:06:59,030
ููŠ ุนู†ุฏู‡ tight ู„ู„ eyelidุŒ ูˆูƒุฃู†ู‡ ูŠู„ุจุณ ุนุฏุณุงุช extended

75
00:06:59,030 --> 00:07:03,130
wearุŒ ุทุจุนู‹ุง ู†ุนุฑู ุนุฏุณุงุช ุงู„ extended wear

76
00:07:03,130 --> 00:07:07,650
ุงู„ู…ุฑูŠุถ ูŠู„ุจุณู‡ุง ู„ู…ุฏุฉ ุฃุณุจูˆุน ูˆุงุญุฏุŒ ูˆูŠู†ุงู… ููŠู‡ุงุŒ ู„ุงุฒู… ุฃู† 

77
00:07:07,650 --> 00:07:11,210
ูŠูƒูˆู† ููŠู‡ุง ุงู„ DK ุนู„ู‰ T very high compared to mean

78
00:07:12,180 --> 00:07:16,460
conventional daily wearุŒ ูู‡ุฐุง ุงู„ู…ุฑูŠุถ ู†ุชูŠุฌุฉ ุงู„

79
00:07:16,460 --> 00:07:20,720
partially dropping ู„ู„ upper eyelid ุฃูˆ ุงู„ tight ู„ู„

80
00:07:20,720 --> 00:07:24,920
upper eyelid ุณูŠูƒูˆู† ูŠู„ุจุณ ุนุฏุณุงุช ุงู„ู„ุจุณ ุงู„ูŠูˆู… ุงู„ุชู‚ู„ูŠุฏูŠ 

81
00:07:24,920 --> 00:07:29,980
ู„ูƒู† ูˆูƒุฃู†ู‡ ู‡ูŠ ุชู…ุซู„ ู…ุงุฐุงุŸ extended wear lenses.

82
00:07:29,980 --> 00:07:35,600
ููŠุญุฏุซ ุนู†ุฏู‡ ู…ุงุฐุงุŸ ุงู„ superior arcuate punctate

83
00:07:35,600 --> 00:07:42,240
staining. ุทูŠุจ ู…ุงุฐุง ู†ุฎุชุงุฑุŸ Superficial punctate

84
00:07:42,240 --> 00:07:47,780
keratitisุŒ ุฃู… ุงู„ superior arcuate stainingุŸ ุทุจุนู‹ุง 

85
00:07:47,780 --> 00:07:52,180
ุงู„ุฃุฎุทุฑ ู‡ูŠ ุงู„ superiorุŒ ู„ุฃู† ู†ูˆุนู‹ุง ู…ุง ุงู„ู…ุฑูŠุถ

86
00:07:52,180 --> 00:07:58,340
ูŠุดุนุฑ ุจูˆุฌูˆุฏ ุฃู„ู…ุŒ okayุŸ ูˆูŠูƒูˆู† ู‡ู†ุงูƒ ุนู†ุฏู‡ ูŠุนู†ูŠ 

87
00:07:58,340 --> 00:08:02,320
ุฃุนุฑุงุถ ู…ุตุงุญุจุฉ ู„ู…ู†ุŸ ู„ู„ clinical scienceุŒ ุจุณ ุทุงู„ู…ุง

88
00:08:02,320 --> 00:08:05,940
ูŠุดุนุฑ ุจุฃู„ู… ู„ู† ุชูƒูˆู† ูุฎุฑุŒ ูŠุนู†ูŠ ุณูŠุฐู‡ุจ ู„ู„ุทุจูŠุจ ู…ุจุงุดุฑุŸ

89
00:08:05,940 --> 00:08:12,980
ุฃูƒูŠุฏ.  ู„ุฃุŒ ุฃูŠุถู‹ุง ุงู„ superficial punctate keratitis ู‡ูŠ 

90
00:08:12,980 --> 00:08:18,780
ู„ู† ุชูƒูˆู† deepุŒ ูŠุนู†ูŠ ุณุชูƒูˆู† ุณุทุญูŠุฉุŒ ูู…ู† ุงู„ู…ู…ูƒู† ุนู„ุงุฌู‡ุงุŒ ูŠุนู†ูŠ

91
00:08:18,780 --> 00:08:21,640
ุจู…ุนู†ู‰ ุฃู†ู‡ ุณูŠูƒูˆู† ุนู†ุฏู‡ mild corneal fluorescein

92
00:08:21,640 --> 00:08:28,700
stainingุŒ ู„ู† ุชุตู„ ู„ู„ู…oderate ุฃูˆ severeุŒ ู„ุฃู† ูƒู„ ู‡ุฐุง

93
00:08:28,700 --> 00:08:32,500
ุณูŠูƒูˆู† ู…ุชุนู„ู‚ ููŠ ู…ู†ุŸ ููŠ ุงู„ corneal epitheliumุŒ ู„ู†

94
00:08:32,500 --> 00:08:37,820
ูŠูƒูˆู† ููŠ ุงู„ stroma ุฃูˆ ุงู„ endothelium. ุจุงู„ู†ุณุจุฉ ู„ู€

95
00:08:37,820 --> 00:08:43,000
Epithelial AbrasionุŒ abrasion ุจู…ุนู†ู‰ ูƒุดุท ู„ู…ู†ุŸ ู„ุทุจู‚ุฉ

96
00:08:43,000 --> 00:08:47,560
ุงู„ู€ corneal epithelium. ุงู„ุขู† ู„ูˆ ูˆุถุนู†ุง ูู„ูˆุฑุณูŠู†

97
00:08:47,560 --> 00:08:52,140
ุณูŠูƒูˆู† ุจุงู„ุดูƒู„ ู‡ุฐุงุŒ ุนุจุงุฑุฉ ุนู† confluentุŒ ุฃูŠ ุจู…ุนู†ู‰ ู…ู†ุทู‚ุฉ 

98
00:08:52,140 --> 00:08:57,280
ู…ุชุฌู…ุนุฉุŒ ุณุชุชุฌู…ุน ูƒู„ู‡ุง ููŠ ุงู„ู…ู†ุทู‚ุฉ ู‡ุฐู‡ ุตุจุบุฉ ุงู„ูู„ูˆุฑุณูŠู†.

99
00:08:57,280 --> 00:09:00,740
Severe 

100
00:09:00,740 --> 00:09:04,420
central fluorescein staining resulting

101
00:09:10,500 --> 00:09:16,160
ุฅุฐุง ููŠ ู‡ุฐู‡ ุงู„ุญุงู„ุฉ ุงู„ู…ุฑูŠุถ ูŠุฌุจ ุฃู† ู„ุง ูŠู„ุจุณ ุงู„ุนุฏุณุฉุŒ 

102
00:09:16,160 --> 00:09:20,180
ู„ุงุฒู… ุฃู† ุฃูˆู‚ูู‡ ุนู† ุงุฑุชุฏุงุก ุงู„ุนุฏุณุฉ ููŠ ุงู„ู€ 

103
00:09:20,180 --> 00:09:21,360
epithelial aberration.

104
00:09:25,750 --> 00:09:31,030
become adherent to the epithelium already weakened 

105
00:09:31,030 --> 00:09:36,510
by hypoxia. ุฅุฐุง ู…ุฏุงู… ุงู„ุนุฏุณุฉ ุชุนู…ู„ adherence to the

106
00:09:36,510 --> 00:09:41,850
eyeุŒ ู…ุนู†ู‰ ุงู„ูƒู„ุงู… ุฅู† ุงู„ุนุฏุณุฉ tight lens. ุฅุฐุง  ู‡ุงู† if

107
00:09:41,850 --> 00:09:46,110
the lens has become adherent to an epitheliumุŒ ุฅุฐุง 

108
00:09:46,110 --> 00:09:52,540
ุงู„ุนุฏุณุฉ tight lens ุฅู†ู‡ no sensation at all. Already

109
00:09:52,540 --> 00:09:58,040
weakened by hypoxiaุŒ ุณูŠุชู… ู„ู‡ุง ุถุนู ุจู†ู‚ุต ุงู„ oxygen 

110
00:09:58,040 --> 00:10:04,820
ุฃูˆ ุฏุฎูˆู„ ุงู„ oxygen ู„ู‡ุฐู‡ ุงู„ู…ู†ุทู‚ุฉ. ุงู„ุงุจุฑุงุดู† ุงู„ูƒุดุท ู‡ุฐุง

111
00:10:04,820 --> 00:10:10,180
will have sharply demarcatedุŒ ุณูŠุนู…ู„ ุดูƒู„ ู…ุฎุทุท ูƒู…ุง 

112
00:10:10,180 --> 00:10:14,080
ู†ุญู† ู†ุดุงู‡ุฏู‡ ููŠ ุงู„ูู„ูˆุฑุณูŠู†. Each and maybe several

113
00:10:14,080 --> 00:10:18,540
millimeters in diameterุŒ ูˆุณูŠูƒูˆู† ู‚ุทุฑ ุดู…ุงู„ู‡ ูƒุจูŠุฑ

114
00:10:18,540 --> 00:10:23,800
ู…ู‚ุงุฑู†ุฉ ุจุงู„ู€ superficial punctate keratitis ุฃูˆ ููŠ 

115
00:10:23,800 --> 00:10:30,180
ุงู„ superior staining. These

116
00:10:30,180 --> 00:10:35,360
are acute conditions. ุฏุงุฆู…ู‹ุง ู‡ุฐู‡ ู…ุงุฐุง ุชูƒูˆู†ุŸ acute

117
00:10:35,360 --> 00:10:41,480
ุญุงุฏุฉ. Significant discomfort or painุŒ ุงู„ู…ุฑูŠุถ ุณูŠุดุนุฑ

118
00:10:41,480 --> 00:10:46,080
ุจู€ ุนุฏู… ุฑุงุญุฉ ูˆุฃู„ู… ุดุฏูŠุฏ. ุทุจุนู‹ุง ู…ุชู‰ ู‡ุฐุง ุงู„ุฃู„ู… ุงู„ุดุฏูŠุฏ

119
00:10:46,080 --> 00:10:51,020
ูŠุธู‡ุฑุŸ ุจุงู„ุถุจุท ุนู†ุฏู…ุง ุงู„ู€ practitioner ูŠู‚ูˆู… ุจุนู…ู„ูŠุฉ 

120
00:10:51,020 --> 00:10:53,180
removal ู„ู„ soft contact lens. 

121
00:10:56,500 --> 00:11:00,940
The lesion is not usually infected by stromal

122
00:11:00,940 --> 00:11:05,980
infiltration is not present. ู‡ู†ุง ููŠ ู‡ุฐู‡ ุงู„ุญุงู„ุฉ ู„ู† 

123
00:11:05,980 --> 00:11:11,880
ูŠุตุงุจ ุงู„ู…ุฑูŠุถ ุจุฃูŠ infection ู„ุฃู† ุงู„ุฃู…ุฑ ู‡ุฐุง ู„ู† ูŠูƒูˆู† 

124
00:11:11,880 --> 00:11:17,800
ุนู„ุงู‚ุฉ ููŠ ุงู„ู€ stromaุŒ ูŠุนู†ูŠ ู„ุง ูŠุคุฐูŠ ุงู„ stromaุŒ ูˆุฏุงุฆู…ู‹ุง

125
00:11:17,800 --> 00:11:21,720
ุงู„infection ูŠูƒูˆู† ู…ุตุงุญุจ ู„ู…ู†ุŸ ู„ู„ู€ stromal.

126
00:11:24,090 --> 00:11:29,070
ุฅุฐุง ูŠุชู…ูŠุฒ ู‡ุฐุง ุงู„ู†ูˆุน ุตุญูŠุญ ุจุดุฏุฉ ุฃู„ู… ูˆุนุฏู… ุฑุงุญุฉ ู„ู„ู…ุฑูŠุถ 

127
00:11:29,070 --> 00:11:35,550
ูˆุฃู† ุงู„ุนุฏุณุฉ ุชูƒูˆู† tight ู…ุน ุงู„ู€ epithelium ูˆุจุณุจุจ hypoxia

128
00:11:35,550 --> 00:11:41,750
ู„ูƒู† rarelyุŒ ู…ู† ุงู„ู†ุงุฏุฑ ุฃู† ูŠุญุฏุซ infection ู„ู„ู…ุฑูŠุถ.

129
00:11:45,900 --> 00:11:51,620
Number fourุŒ micro cystุŒ ูˆ vacuousุŒ micro cyst ู…ุงุฐุง

130
00:11:51,620 --> 00:11:58,760
ู…ุนู†ุงู‡ุงุŸ ู‡ูˆ ูƒูŠุณุŒ ูˆ vacuous ุจู…ุนู†ู‰ ูุฑุงุบุงุชุŒ ุทุจุนู‹ุง ูŠูƒูˆู†

131
00:11:58,760 --> 00:12:05,060
ุจุงู„ุดูƒู„ ู‡ุฐุงุŒ ุงู„ู†ู‚ุงุท ุงู„ุจูŠุถุงุกุŒ ูˆู…ู†ุทู‚ุชู‡ุง ูŠุนู†ูŠ ูŠูƒูˆู† ุงู„

132
00:12:05,060 --> 00:12:13,130
area ููŠ ุงู„ superior part ููŠ ุงู„ุบุงู„ุจ. Translucent cystุŒ

133
00:12:13,130 --> 00:12:17,730
ุฃูŠ ุจู…ุนู†ู‰ ุงู„ู„ูŠ ู‡ูˆ ุฃูƒูŠุงุณ ุชูƒูˆู† ุดุจู‡ ุดูุงูุฉ in the

134
00:12:17,730 --> 00:12:23,790
epitheliumุŒ 0.01 to 0.1 millimeter in diameter. ุฅุฐุง

135
00:12:23,790 --> 00:12:28,790
ู‚ุทุฑู‡ุง ู…ุงุฐุง ู†ู„ุงุญุธู‡ุŸ ุฃู†ู‡ very smallุŒ ูˆู‡ุฐุง ูŠุนุทูŠู†ูŠ

136
00:12:28,790 --> 00:12:33,950
indicatorุŒ ู…ุคุดุฑ ุฃู†ู‡ ู„ุง ูŠู…ูƒู† ุฑุคูŠุชู‡ุง ุจุงู„ุนูŠู† ุงู„ู…ุฌุฑุฏุฉ. 

137
00:12:33,950 --> 00:12:41,740
ุฅุฐุง ุชุญุชุงุฌ ู…ุงุฐุงุŸ microscope. ููŠ ู‡ู†ุงูƒ ุทุฑูŠู‚ุฉ ู…ู† ุฎู„ุงู„

138
00:12:41,740 --> 00:12:46,400
ุงู„ู€ retro illumination ูŠู…ูƒู† ุฃู† ุฃุฑู‰ ู‡ุฐู‡ ุงู„ุฃูƒูŠุงุณุŒ 

139
00:12:46,400 --> 00:12:52,500
ูˆู„ูƒู† ุชุญุชุงุฌ ู„ุฎุจุฑุฉ ูƒุจูŠุฑุฉ ู…ู† ุงู„ examiner. ุทูŠุจ ุฃู†ุง ูƒ

140
00:12:52,500 --> 00:12:56,580
beginnerุŒ ู…ุจุชุฏุฆุŒ ูƒูŠู ุฃุนุฑู ุฃู† ู‡ุฐุง ุงู„ู…ุฑูŠุถ ุนู†ุฏู‡ micro 

141
00:12:56,580 --> 00:13:01,160
zest ุฃูˆ ุงูƒุชุดู ู‡ุฐุง ุงู„ุฃู…ุฑุŸ ุงู„ุจุณุงุทุฉ ุฃู†ูŠ ุฃุนู…ู„ ุงู„

142
00:13:01,160 --> 00:13:06,120
corneal fluorescein staining ู…ู…ูƒู† ุฃู†ู‘ู‡ ูŠุฏูŠู†ูŠ ุงู†ุทุจุงุน

143
00:13:06,120 --> 00:13:09,820
ุฃูˆ ู…ุคุดุฑ ุฅุฐุง ุงู„ู…ุฑูŠุถ ูƒุงู† ุนู†ุฏู‡ micro zest

144
00:13:13,110 --> 00:13:24,990
ุงู„ู…ูŠูƒุฑูˆุฒูŠูƒุณ ุตุบูŠุฑ ูˆู‚ู„ูŠู„ ู…ู† ุงู„ูุฌูˆุงุช ุจุดูƒู„

145
00:13:28,460 --> 00:13:33,120
destination is uncertain  ุงู„ุชู‘ู†ุชูŠู†ุงุช ุบูŠุฑ ู…ุญุฏุฏุฉ ุงู„

146
00:13:33,120 --> 00:13:38,160
function ู„ู‡ู… ูŠุนู†ูŠ ู„ุญุฏ ุงู„ุขู† ุงู„ micro zest ูˆ ุงู„

147
00:13:38,160 --> 00:13:43,240
vacuous ุงู„ุชู‘ู†ุชูŠู†ุงุช without function ุจุฏูˆู† ุฃูŠ ูˆุธูŠูุฉ

148
00:13:45,730 --> 00:13:50,090
It takes 6 to 8 weeks of extended wear with

149
00:13:50,090 --> 00:13:55,990
hydrogel lenses before micro-zest appear ุฏุงุฆู…ุงู‹

150
00:13:55,990 --> 00:14:01,810
ุจุชุฃุฎุฐ ู…ุฏุฉ ู…ู† 6 ู„ 8 ุฃุณุงุจูŠุน ู„ุธู‡ูˆุฑ ู…ู† ุงู„ micro-zest

151
00:14:01,810 --> 00:14:07,090
ุฃูˆ ุงู„ vaculus ุทุจ ู‡ู„ ู‡ูŠ ุจุชุชุนู„ู‚ ููŠ ุงู„

152
00:14:07,090 --> 00:14:11,090
daily wear ุฃู‚ุตุฏ ุงู„ู„ูŠ ู‡ูˆ ุงู„ daily disposable lenses

153
00:14:11,090 --> 00:14:14,250
ูˆู„ุง ุงู„ extended wear ูˆู„ุง ุงู„ conventional daily

154
00:14:14,250 --> 00:14:18,550
wearู„ู‡ุง ุนู„ุงู‚ุฉ ููŠ ุงู„ extended wear ูˆ ุงู„

155
00:14:18,550 --> 00:14:22,230
conventional daily wear ู„ูŠู‡ุŸ ู„ุฃู†ู‘ู‡ ุจู…ุนู†ู‰ ู‡ูŠ

156
00:14:22,230 --> 00:14:25,370
chronicุŒ ู…ุง ุจุชูŠุฌูŠ ุจุดูƒู„ ุฃูŠู‘ู‡ ู…ูุงุฌุฆ

157
00:14:30,010 --> 00:14:35,410
One clue ูŠุนู†ูŠ ูˆุงุญุฏุฉ ู…ู† ุงู„ุฃููƒุงุฑ to the presence

158
00:14:35,410 --> 00:14:41,630
ู„ุธู‡ูˆุฑ of microcyst or vacuous may be scattered by

159
00:14:41,630 --> 00:14:45,150
nectarine fluorocene staining ุฒูŠ ู…ุง ุงุชูู‚ู†ุง ุฃู†

160
00:14:45,150 --> 00:14:50,170
ูˆุงุญุฏุฉ ู…ู† ุงู„ุญู„ูˆู„ ุฃูˆ ูˆุงุญุฏุฉ ู…ู† ุงู„ู…ุคุดุฑุงุช ุฃู† ู‡ุฐุง ุงู„ู…ุฑูŠุถ

161
00:14:50,170 --> 00:14:55,250
ุนู†ุฏู‡ microcyst ุฃูˆ vacuous ู…ู† ุฎู„ุงู„ ุฃูŠู‘ู‡ ุฃู† ุงุณุชุฎุฏู…

162
00:14:55,250 --> 00:14:56,470
ุงู„ู‚ุฑู†ูŠุฉ ู„ูู„ูˆุฑูˆุณูŠู†

163
00:14:59,640 --> 00:15:05,760
ูŠุนู†ูŠ ูˆุฌูˆุฏู‡ุง ุฃูˆ ุนุฏู… ูˆุฌูˆุฏู‡ุง ุทุจุนุงู‹ ุงู„ุฃุฑุจุนุฉ ู‡ุฏูˆู„ ู„ุง

164
00:15:05,760 --> 00:15:11,100
ูŠูุนุชุจุฑูˆู† ู…ุฎูŠูุงุช ุจุดูƒู„ ูƒุจูŠุฑ ู„ุฃู† ู…ูˆู‚ุนู‡ู… ูƒู„ู‡ ูˆูŠู† ููŠ ุงู„

165
00:15:11,100 --> 00:15:16,180
corneal epithelia management

166
00:15:16,180 --> 00:15:20,620
ุฃูŠู‘ ุจู…ุนู†ู‰ ุงู„ุนู„ุงุฌ ุฃูˆ ุขู„ูŠุฉ ุงู„ุนู„ุงุฌ ุฃูˆ ุงู„ุทุฑูŠู‚ุฉ

167
00:15:20,620 --> 00:15:26,460
significant epithelial staining ุงู„ู…ู‚ุตูˆุฏ ููŠู‡ุง ุฅู…ู‘ุง

168
00:15:26,460 --> 00:15:34,390
moderate ุฃูˆ severe24 hour discontinuation of lens

169
00:15:34,390 --> 00:15:38,770
wear ุฅุฐุง ุงู„ุดุฎุต ูƒุงู† ุนู†ุฏู‡ severe ุฃูˆ moderate

170
00:15:38,770 --> 00:15:43,650
staining ูˆุธู‡ุฑ ุนู†ุฏู‡ ุงู„ุญุงู„ุงุช ู‡ุฏูˆู„ ุงู„ุฃุฑุจุนุฉ ุจุนู…ู„ ุนู…ู„ูŠุฉ

171
00:15:43,650 --> 00:15:49,150
ุชูˆู‚ูŠู ู„ุงุฑุชุฏุงุก ุงู„ุนุฏุณุฉ ู„ู…ุฏุฉ 24 ุณุงุนุฉ ู‡ู„ ุฃูŠุด ุจู†ู‚ุตุฏ ุงู„

172
00:15:49,150 --> 00:15:53,210
conventional daily wear ุทุจุนุงู‹ ุฅุฐุง ูƒุงู†ุช extended

173
00:15:53,210 --> 00:15:58,430
wear ุฃูˆ daily disposable lenses ุจู†ูˆู‚ูู‡ุง ุจุดูƒู„ ุฃูŠู‘ู‡ุŸ

174
00:15:58,430 --> 00:16:04,190
ูƒุงู…ู„ ู…ุฑุฉ ุชุงู†ูŠุฉุŒ ุงู„ุขู† ุฅุฐุง ูƒุงู† ุงู„ู…ุฑูŠุถ ุนู†ุฏู‡ moderate

175
00:16:04,190 --> 00:16:07,930
ุฃูˆ severe staining ูˆูƒุงู† ุจูŠู„ุจุณ conventional daily

176
00:16:07,930 --> 00:16:16,090
wear ุจูˆู‚ู ุงุฑุชุฏุงุก ุงู„ุนุฏุณุฉ ู„ู…ุฏุฉ ูƒุฏู‡ุŸ 24 ุณุงุนุฉ ุทุจุนุงู‹ ุฅุฐุง

177
00:16:16,090 --> 00:16:19,630
ุธู‡ุฑุช ุนู†ุฏูŠ ุงู„ุฃุฑุจุน ุญุงู„ุงุช ู‡ุฏูˆู„ ุงู„ superfacial

178
00:16:19,630 --> 00:16:23,230
panictate keratitis ุฃูˆ ุงู„ superior arcuate

179
00:16:23,230 --> 00:16:27,130
panictate staining ุฃูˆ epithelial aberration ุฃูˆ ุงู„

180
00:16:27,130 --> 00:16:34,370
micro zestุฅุฐุง ู…ุง ุธู‡ุฑูˆุง ุฎู„ุงุต ุฃู† ุงู„ู…ุฑูŠุถ ุจูŠุณุชู…ุฑ ููŠ

181
00:16:34,370 --> 00:16:39,810
ุงุฑุชุฏุงุก ุงู„ุนุฏุณุฉ ุทูŠุจ ุจุนุถ ุงู„ุฃุญูŠุงู† ุฃู†ุช ุจุชุนู…ู„ ุงู„ูุญุต ูˆู„ูƒู†

182
00:16:39,810 --> 00:16:44,250
ุฃู†ู‘ู‡ ุจูŠุตูŠุฑ ุฃูŠู‘ู‡ ุงู„ู„ูŠ ู‡ูˆ absent ุบูŠุงุจ ุฅู„ู‡ุง ูŠุนู†ูŠ ุจู…ุนู†ู‰

183
00:16:44,250 --> 00:16:48,330
ุงู„ุขู† ุฃู†ุง ุชูˆู‚ูุช ุฃุฑุจุน ูˆุนุดุฑูŠู† ุณุงุนุฉ ุนู† ุงุฑุชุฏุงุก ุงู„ุนุฏุณุฉ

184
00:16:48,330 --> 00:16:51,650
ุฑุญุช ุนู…ู„ุช corneal florescence stain ู…ุฑุฉ ุชุงู†ูŠุฉ

185
00:16:51,650 --> 00:16:56,350
ู…ุง ุธู‡ุฑุด ุงู„ุจุงู†ูƒุชูŠุช ูƒูŠุฑูˆุชุงูŠุชุณ ุฃูŠุด ุจุฏูŠ ุฃุนู…ู„ ููŠ ู‡ุฐู‡

186
00:16:56,350 --> 00:17:01,480
ุงู„ุญุงู„ุฉุŸ ุจุฑุฌุน ุฃู„ุจุณ ุงู„ุนุฏุณุฉูˆู„ูƒู† ุฅุฐุง ูƒุงู† ู‡ุฐุง ุงู„ู…ุฑูŠุถ

187
00:17:01,480 --> 00:17:07,440
ุจูŠู„ุจุณ extended wear ุฃูˆ daily disposable lensesุŒ ุจุฏู‡

188
00:17:07,440 --> 00:17:11,640
ูŠุชูˆู‚ู ุจุดูƒู„ ูƒุงู…ู„ุŒ ููŠ ุญุงู„ุฉ ู…ูŠู†ุŸ ุงู„ู€ significant

189
00:17:11,640 --> 00:17:18,340
stainingุŒ ุงู„ู„ูŠ ู‡ูŠ ุงู„ moderate ุฃูˆ ุงู„ุณูŠููŠุฑุŒ mild

190
00:17:18,340 --> 00:17:25,220
staining ูŠุนู†ูŠ grade oneุŒ reducing wearing timeุŒ

191
00:17:25,220 --> 00:17:30,340
ุจุฏู†ุง ู†ู‚ู„ู„ ู…ู† ุณุงุนุงุช ุงุฑุชุฏุงุก ุงู„ุนุฏุณุฉfor example to

192
00:17:30,340 --> 00:17:35,720
less than ten hours beer day or ceasing extended

193
00:17:35,720 --> 00:17:36,040
wear

194
00:17:41,320 --> 00:17:45,460
ุจู†ู‚ูˆู„ ู„ู‡ ูู‚ุท ู„ุจุณ ุงู„ุนุฏุณุฉ ุฃุฑุจุน ุณุงุนุงุช ุฃูˆ ุณุงุนุชูŠู† ุฃูˆ

195
00:17:45,460 --> 00:17:50,880
ุซู„ุงุซุฉ ูŠุนู†ูŠ ุงู„ู…ู‡ู… ุฃู†ู‘ู‡ ุฃูˆู‚ู ู…ู† ุนุฏุฏ ูŠุนู†ูŠ ุฃูˆู‚ู ุงู„ู„ูŠ ู‡ูˆ

196
00:17:50,880 --> 00:17:54,700
ุนุฏุฏ ุงู„ุณุงุนุงุช ุงุฑุชุฏุงุก ุงู„ุนุฏุณุฉ ุทุจ ู„ูˆ ูƒุงู†ุช extended

197
00:17:54,700 --> 00:17:59,880
wear ุฃูˆ daily disposable lenses ุจู†ูˆู‚ูู‡ุง ุจุดูƒู„ ูƒุงู…ู„

198
00:17:59,880 --> 00:18:04,080
ุญุชู‰ ููŠ ุงู„ mild ุญุชู‰ ููŠ ุงู„ mild staining ู„ูŠู‡ุŸ ู„ุฃู†ู‘ ุงู„

199
00:18:04,080 --> 00:18:07,440
mild staining ู„ูˆ ู„ุจุณ ุงู„ุนุฏุณุฉ ู„ู…ุฏุฉ ุฃุณุจูˆุน ุจูŠุตูŠุฑ

200
00:18:07,440 --> 00:18:08,400
moderate ุฃูˆ severe

201
00:18:12,570 --> 00:18:16,250
if the staining is chronic ูŠุนู†ูŠ ู‡ุฐุง ูƒุงู† ุงู„

202
00:18:16,250 --> 00:18:20,050
staining ู…ุถู…ู† ุนู†ุฏ ุงู„ุดุฎุต ู…ู† ู‚ุจู„ ุญุชู‰ ู…ุง ูŠุฑุชุฏูŠ ุนุฏุณุฉ

203
00:18:20,050 --> 00:18:25,170
ู„ุงุตู‚ุฉ even if it's light or mild ุญุชู‰ ู„ูˆ ูƒุงู† ุจุณูŠุท

204
00:18:25,170 --> 00:18:30,770
modification ุฃูŠู‘ ุจู…ุนู†ู‰ ุชุนุฏูŠู„ of lens parameters ุฃู†ุง

205
00:18:30,770 --> 00:18:35,650
ุจุฏูŠ ุฃุนู…ู„ ุนู…ู„ูŠุฉ ุชุนุฏูŠู„ ู„ู…ูŠู†ุŸ ู„ู€ parameters ุงู„ู„ูŠ ุฎุงุตุฉ

206
00:18:35,650 --> 00:18:42,370
ููŠ ุงู„ุนุฏุณุฉ to increase dk ุนู„ู‰ t is advisableุทุจ ู‡ุฐุง

207
00:18:42,370 --> 00:18:55,410
ุงู„ูƒู„ุงู… ู…ู…ูƒู† ูŠูƒูˆู† ุฎุทุฃ ุตุญุŸ ู…ูŠู† ุจุชูู‚ ู…ุนุงูŠุงุŸ ู…ู…ุชุงุฒุฉ

208
00:18:55,410 --> 00:19:01,090
ุจุงู„ุถุจุทุŒ ูŠุนู†ูŠ ุงู„ุขู† ู…ุซู„ุงู‹ ุดุฎุต ูƒุงู† ุนู†ุฏู‡ dry eye ููŠ ุจุนุถ

209
00:19:01,090 --> 00:19:05,150
ุงู„ุฃุญูŠุงู† ู‚ุฏ ูŠูƒูˆู† ู…ุตุงุญุจ ู„ู‡ ุฃูŠู‘ู‡ุŸ ุงู„ corneal

210
00:19:05,150 --> 00:19:10,430
fluorescein staining  ุฑุญุช ุฃู†ุง ุฒูˆุฏุช ุงู„ DK ุนู„ู‰ TุฃูŠุด

211
00:19:10,430 --> 00:19:15,770
ุตุงุฑุŸ ุฒูˆุฏ ุงู„ุฌูุงู ูŠุนู†ูŠ ุงู„ dry eye symptoms ุตุงุฑ ุฃูƒุซุฑ

212
00:19:15,770 --> 00:19:20,270
ุธู‡ูˆุฑ ู„ู‡ุฐุง ุงู„ุดุฎุต ูุฃู†ุง ุฃูŠุด ุนู…ู„ุช ููŠ ู‡ุฐู‡ ุงู„ุญุงู„ุฉุŸ ุฃุณุฃุช

213
00:19:20,270 --> 00:19:25,130
ุงู„ู„ูŠ ู‡ูˆ ุฃูƒุซุฑ ู„ู€ ุงู„ patient ูˆุงุถุญุฉ ุงู„ููƒุฑุฉุŸ ูุฏุงูŠู…ุงู‹ ุงู„

214
00:19:25,130 --> 00:19:30,130
parameters ู…ุด ุงู„ู…ู‚ุตูˆุฏ ููŠู‡ุง ุงู„ู„ูŠ ู‡ูˆ ุฃู†ู‘ู‡ ูู‚ุท ุฃุฒูˆุฏ ุงู„

215
00:19:30,130 --> 00:19:34,930
DK ุนู„ู‰ T ู„ุง ู„ุงุฒู… ุฃู†ุง ุฃุฑุงุนูŠ ูƒู„ ุงู„ุธุฑูˆู ูŠุนู†ูŠ ู…ู…ูƒู† ุฃู†ุง

216
00:19:34,930 --> 00:19:40,660
ุฃุบูŠุฑ ุงู„ thickness ุฏูˆู† ุชุบูŠูŠุฑ ู…ูŠู†ุŸ ุงู„ DK ุนู„ู‰ TูƒูŠู

217
00:19:40,660 --> 00:19:44,680
ุทูŠุจุŸ ู…ู…ูƒู† ู…ุซู„ุงู‹ ู‡ูˆ ุจูŠู„ุจุณ low water content ุจุฎู„ูŠู‡

218
00:19:44,680 --> 00:19:48,000
medium water content ูˆู„ูƒู† ุจู‚ู„ู„ ุงู„ mean ุงู„

219
00:19:48,000 --> 00:19:53,520
thickness ูุฏุงูŠู…ุงู‹ ูŠุนู†ูŠ ุงุฎุชูŠุงุฑ ุงู„ option ู…ู‡ู… ูƒุซูŠุฑ ููŠ

220
00:19:53,520 --> 00:19:54,720
ุฌู…ูŠุน ุงู„ุธุฑูˆู

221
00:19:59,590 --> 00:20:04,630
Superior arcuate panectate staining may require an

222
00:20:04,630 --> 00:20:09,850
improvement to peripheral lensุŒ DK ุนู„ู‰ T ูˆู‡ุฐุง ุฃู…ุฑ

223
00:20:09,850 --> 00:20:16,190
ุทุจูŠุนูŠ ู„ุฃู†ู‘ู‡ ู‡ูˆ ุนู†ุฏู‡ tight upper eyelid ุฃูˆ ููŠ ุนู†ุฏู‡ ..

224
00:20:16,190 --> 00:20:21,830
ููŠ ุนู†ุฏู‡ partially toses ูููŠ ู‡ุฐู‡ ุงู„ุญุงู„ุฉ ุฃู†ุง ุฃูŠุด ุจุฏูŠ

225
00:20:21,830 --> 00:20:27,440
ุฃุนู…ู„ุŸ ุฃุฒูˆุฏ ุงู„ู€DK ุนู„ู‰ T ู…ู† ุงู„ุฃุทุฑุงู ุนุดุงู† ุฃูŠุด ูŠุนู…ู„

226
00:20:27,440 --> 00:20:33,200
ุฒูŠุงุฏุฉ ู„ุฏุฎูˆู„ ุงู„ oxygen ูˆูŠู†ุŸ ููŠ ุงู„ุฃุทุฑุงู whereas

227
00:20:33,200 --> 00:20:38,240
ุจูŠู†ู…ุง central staining may indicate the need to

228
00:20:38,240 --> 00:20:43,360
improve central corneal oxygenation ู„ูƒู† ู„ูˆ ูƒุงู†

229
00:20:43,360 --> 00:20:46,620
ุนู†ุฏู‡ ุงู„ุญุงู„ุฉ ุงู„ุฃูˆู„ู‰ ุงู„ superficial panictate

230
00:20:46,620 --> 00:20:50,700
keratitis ู„ุฌูŠู†ุง ุฅู† ูƒู„ ุงู„ staining ูˆูŠู† ู…ูˆุฌูˆุฏุŸ ููŠ ุงู„

231
00:20:50,700 --> 00:20:54,340
center ูุฃู†ุง ุจุฏูŠ ุฃุฒูˆุฏ ุงู„ DK ุนู„ู‰ T ูˆูŠู†ุŸ ููŠ ุงู„ center

232
00:20:59,450 --> 00:21:04,870
Unlike ocular changes with other causes, ocular

233
00:21:04,870 --> 00:21:10,250
changes related to hypoxia and hypercapnia tend to

234
00:21:10,250 --> 00:21:14,410
affect only the cornea, and there are a few

235
00:21:14,410 --> 00:21:20,570
associated symptoms ุฏุงุฆู…ุงู‹ ุงู„ุฃุนุฑุงุถ ุงู„ู„ูŠ ุจุชุณุจุจู‡ุง

236
00:21:20,570 --> 00:21:25,210
ุงู„hypercapnia ุฃูˆ ุงู„hypoxia ุจุชูƒูˆู† ู…ุชุนู„ู‚ุฉ ููŠ

237
00:21:25,210 --> 00:21:30,250
ุงู„ู‚ุฑู†ูŠุฉ ููŠ ุจุนุถ ุงู„ุฃุญูŠุงู† ุจุชูƒูˆู† ู…ุตุงุญุจุฉ ู„ู„ุฃุฌุฒุงุก ุงู„ู„ูŠ

238
00:21:30,250 --> 00:21:35,630
ุญูˆุงู„ูŠู† ู…ูŠู†ุŸ ุงู„ู‚ุฑู†ูŠุฉ ุฒูŠ ู…ุซู„ุงู‹ ุฃูŠุด ูŠุง ุฑุบุฏุŸ ุฒูŠ ู…ุซู„ุงู‹

239
00:21:35,630 --> 00:21:41,230
ุนู†ุฏู†ุง ุงู„ eyelid ุฃู†ู‘ู‡ ูŠุตูŠุฑ ุนู†ุฏู‡ eyelid disorders ุฃูˆ

240
00:21:41,230 --> 00:21:45,090
ู…ุซู„ุงู‹ ูŠุตูŠุฑ ุนู†ุฏู‡ conjunctival staining ูู‡ุฐู‡ ู‡ูŠูƒูˆู†

241
00:21:45,090 --> 00:21:51,370
ู…ุตุงุญุจุฉ ู„ู…ูŠู†ุŸ ู„ู„ู‚ุฑู†ูŠุฉ disorders ูˆ ุจุงู„ุชุงู„ูŠ ุงู„ู…ุฑูŠุถ

242
00:21:51,370 --> 00:21:55,110
ู‡ูŠุตูŠุฑ ุนู†ุฏู‡ ุดูƒูˆู‰ ุฃูƒุซุฑ ููŠ ู‡ุฐุง ุงู„ุฃู…ุฑ

243
00:21:59,300 --> 00:22:05,500
Stromal Edema ุทุจุนุงู‹ ุจุฏุงูŠุฉ ุงู„ุงุณุชุฑูˆู…ุฉ ุฃูˆ ุงู„

244
00:22:05,500 --> 00:22:10,300
Substantia Epropria ู‡ูŠ ุจุชู…ุซู„ ุชุณุนูŠู† ููŠ ุงู„ู…ุฆุฉ ุชู‚ุฑูŠุจุงู‹

245
00:22:10,300 --> 00:22:17,470
ู…ู† ุณู…ุงูƒุฉ ู…ูŠู†ุŸ ุงู„ู‚ุฑู†ูŠุฉarises within hours of the

246
00:22:17,470 --> 00:22:23,070
onset of hypoxiaุŒ ุงู„ุขู† ุงู„ู€ hypoxia ู„ู… ุชูƒุชููŠ ูู‚ุท ููŠ

247
00:22:23,070 --> 00:22:27,610
ุงู„ุชุฃุซูŠุฑ ุนู„ู‰ ุงู„ู€ corneal epitheliumุŒ ุจูŠู†ู…ุง ุงู…ุชุฏ

248
00:22:27,610 --> 00:22:33,470
ุงู„ุฃู…ุฑ ู„ูˆูŠู†ุŸ ู„ู„ุงุณุชุฑูˆู…ุฉุŒ ุฏุงุฆู…ุงู‹ ู„ู…ุง ุชุณู…ุน ุฃู† ููŠ ู‡ู†ุงูƒ

249
00:22:33,470 --> 00:22:38,150
defect ู…ูˆุฌูˆุฏ ููŠ ุงู„ุงุณุชุฑูˆู…ุฉุŒ ููŠ ุงู„ุบุงู„ุจ ู‡ูŠูƒูˆู† ู…ุตุงุญุจ

250
00:22:38,150 --> 00:22:42,690
ู„ู‡ infection ุฒูŠ ุงู„ุงุณุชุฑุงู…ุฉ ุงู„ infiltration

251
00:22:46,690 --> 00:22:50,470
The degree being related to the severity of the

252
00:22:50,470 --> 00:22:56,310
hypoxia ูˆู‡ุฐุง ุจุงู„ุฃุณุงุณ ุจูŠุนุชู…ุฏ ุนู„ู‰ ุญุฏุฉ ุงู„ู‡ูŠุจูˆูƒุณูŠุฉ ูƒู„

253
00:22:56,310 --> 00:23:01,710
ู…ุง ุฒุงุฏุช ุงู„ู‡ูŠุจูˆูƒุณูŠุฉ ูƒู„ ู…ุง ูƒุงู† ู‡ู†ุงูƒ ุนุฑุถุฉ ุฃูƒุซุฑ ู„ุญุฏูˆุซ

254
00:23:01,710 --> 00:23:06,830
ู…ู† ุงู„ู‡ูŠุจูˆูƒุณูŠุฉ

255
00:23:06,830 --> 00:23:09,830
ุงู„ู‡ูŠุจูˆูƒุณูŠุฉ related increase

256
00:23:11,810 --> 00:23:16,590
In anaerobic metabolism ุฏุงุฆู…ุงู‹ ุฅู„ู‡ุง ุนู„ุงู‚ุฉ ููŠ ุฒูŠุงุฏุฉ

257
00:23:16,590 --> 00:23:22,190
ู…ูŠู†ุŸ ุนู…ู„ูŠุฉ ุงู„ู‡ุฏู…ุŒ ุนู†ุฏู†ุง ุงู„ aerobic metabolism

258
00:23:22,190 --> 00:23:27,350
ุนู…ู„ูŠุฉ ุงู„ุจู†ุงุกุŒ ุงู„ anaerobic metabolism ุนู…ู„ูŠุฉ ุงู„ู‡ุฏู…

259
00:23:28,670 --> 00:23:34,070
via the Emden-Meyerhof biochemical pathway of the

260
00:23:34,070 --> 00:23:40,170
epithelial cells ุทุจุนุงู‹ ุนู…ู„ูŠุฉ ุงู„ู‡ุฏู… ู‡ูŠ ู…ุตุงุญุจุฉ ู„ู‡ุคู„ุงุก

261
00:23:40,170 --> 00:23:46,370
ุงู„ุนุงู„ู…ูŠู† Emden and Meyerhof ุงู„ู„ูŠ ุนู…ู„ูˆุง ุชุฌุงุฑุจ ุทุจุนุงู‹

262
00:23:46,370 --> 00:23:50,490
ูƒุงู†ุช ู‡ุฐู‡ ุงู„ุชุฌุงุฑุจ ู…ู† ุฎู„ุงู„ ุฃุฎุฐ ุนูŠู†ุฉ ู…ู† ุงู„ tiers

263
00:23:50,490 --> 00:23:54,630
ูˆุชุญู„ูŠู„ ุงู„ protein ุงู„ู„ูŠ ู…ูˆุฌูˆุฏ ููŠ ุงู„ tier ูˆุจุนุฏ ุฐู„ูƒ

264
00:23:54,630 --> 00:24:00,110
ุชุญู„ูŠู„ ู…ุง ู‡ูˆ ู…ุตุงุญุจ ู„ู€ defect ุงู„ู„ูŠ ุญุฏุซ ููŠ ุงู„ corneal

265
00:24:00,110 --> 00:24:05,510
epithelium ูˆ ุงู„ stroma accumulation ุฃู†ู‘ู‡ ุตุงุฑ ููŠ

266
00:24:05,510 --> 00:24:10,590
ู‡ู†ุงูƒ ุชุฑุงูƒู… of lactate ู„ู„ุฃู…ู„ุงุญ ูˆูŠู† ู‡ุฐุง ุงู„ุชุฑุงูƒู… ุญุฏุซุŸ

267
00:24:10,590 --> 00:24:16,770
in the stromaุงู†ูู„ูˆู‡ ุทุจุนุงู‹ ุตุงุฑ ู‡ู†ุงูƒ ุชุฏูู‚ of water

268
00:24:16,770 --> 00:24:22,290
into the stroma ูˆุญุฏุซ ุฃูŽุฏููŠู…ูŽุฉ ูŠุนู†ูŠ ุจู…ุนู†ู‰ ุฃู†ู‘ู‡ ุฃูŠุด ุญุฏุซ

269
00:24:22,290 --> 00:24:28,390
ุญุงุฌุฉ ุญุงุฌุฉ ุจู†ุณู…ูŠู‡ุง ุงู„ swelling of

270
00:24:28,390 --> 00:24:37,530
the stroma ุฅุฐุง ุญุฏุซ ุงู†ุชูุงุฎ ู„ู…ูŠู†ุŸ ู„ู„ุงุณุชุฑูˆู…ุฉ

271
00:24:41,440 --> 00:24:48,370
corneal thickness ุฒูŠุงุฏุฉ ุงู„ุณู…ุงูƒุฉ ุทุจุนุงู‹ ุฒูŠุงุฏุฉ ุงู„ุณู…ุงูƒุฉ

272
00:24:48,370 --> 00:24:54,770
ู„ูŠุณ ู…ู† ุงู„ุณู‡ู„ ุนู…ู„ูŠุฉ ุชู‚ูŠูŠู…ู‡ุง ูƒู„ูŠู†ูŠูƒูŠุงู‹ ุทุจุนุงู‹ ุงุญู†ุง ุจู†ุนุฑู

273
00:24:54,770 --> 00:25:00,030
ุฃู† ู‚ูŠุงุณ ุณู…ุงูƒุฉ ุงู„ู‚ุฑู†ูŠุฉ ู…ู…ูƒู† ุฃู† ูŠุชู… ู…ู† ุฎู„ุงู„ ุฌู‡ุงุฒ ุงู„

274
00:25:00,030 --> 00:25:05,750
ุจุงูƒู…ูŠุชุฑ ูˆู„ูƒู† ุงู„ุขู† ุฒูŠุงุฏุฉ ุณู…ุงูƒุฉ ุงู„ู‚ุฑู†ูŠุฉ ู†ุชูŠุฌุฉ

275
00:25:05,750 --> 00:25:10,190
ุงุฑุชุฏุงุก ุงู„ุนุฏุณุฉ ุงู„ู„ุงุตู‚ุฉ ู…ุด ู…ู† ุงู„ุณู‡ู„ ุชู‚ูŠูŠู…ู‡ุง ู„ูŠู‡ุŸ ู„ุฃู†ู‘

276
00:25:10,190 --> 00:25:16,570
ู…ู…ูƒู† ู…ุซู„ุงู‹ ููŠ ุงู„ุตุจุงุญ ูŠูƒูˆู† ุงู„ุณู…ุงูƒุฉ 500ุจุนุฏ ุงู„ุธู‡ุฑ ูŠูƒูˆู†

277
00:25:16,570 --> 00:25:22,790
ู…ุซู„ุงู‹ ุฃุฌู„ุŒ ู…ุซู„ุงู‹ 450ุŒ ุจุนุฏ ุฐู„ูƒ ููŠ ุงู„ู„ูŠู„

278
00:25:22,790 --> 00:25:27,650
ู…ู…ูƒู† ูƒู…ุงู† ุชู‚ู„ ุฃูƒุซุฑุŒ ูููŠ ู…ู„ุงุญุธูŠู† ุฃู†ู‘ variation ู…ู†

279
00:25:27,650 --> 00:25:32,830
ุญูŠุซ ู…ูŠู†ุŸ ุงู„ values ุฃูˆ ุงู„ numbers ูƒู„ ูุชุฑุฉ ุฒู…ู†ูŠุฉ

280
00:25:32,830 --> 00:25:38,470
ู‡ุชุฎุชู„ู ุนู† ุงู„ูุชุฑุฉ ุงู„ุฒู…ู†ูŠุฉ ุงู„ุซุงู†ูŠุฉ ูˆู‡ุฐู‡ ู‡ูŠ ุฏุงุฆู…ุงู‹ ุงู„ 

281
00:25:38,470 --> 00:25:42,250
complications ุงู„ู„ูŠ ู…ุตุงุญุจุฉ ู„ู…ูŠู†ุŸ ู„ู„ู€ soft contact 

282
00:25:42,250 --> 00:25:47,490
lens ุงู„ู„ูŠ ู…ู† ุงู„ุตุนุจ ุฃู† ุงู„ู…ุฑูŠุถ ูŠูƒุชุดูู‡ุง ูŠุนู†ูŠ ู…ูŠู† ู…ู†ู†ุงุŸ

283
00:25:47,490 --> 00:25:51,450
ุงู„ุขู† ู„ูˆ ุจู„ุจุณ soft contact lens ูŠุนู…ู„ ุชู„ุช ู…ุฑุงุช ู‚ูŠุงุณ

284
00:25:51,450 --> 00:25:54,450
ู„ู„ู€ corneal thicknessุŸ ู‡ูŠูƒูˆู† ู‚ู…ุฑ ู…ุฌู‡ุฏ

285
00:25:56,890 --> 00:26:01,330
ุฅุฐุง is not simple ู„ูŠุณ ู…ู† ุงู„ุณู‡ู„ ุฃูˆ ู…ู† ุงู„ุจุณูŠุท to

286
00:26:01,330 --> 00:26:06,410
measure clinically ู‚ูŠุงุณู‡ุง ุจุงู„ุนูŠุงุฏุฉ ุฃูˆ ููŠ ุงู„ู€ center

287
00:26:06,410 --> 00:26:12,610
The edema response ุฏุงูŠู…ุง ุงุณุชุฌุงุจุฉ ุงู„ู€ edema begins

288
00:26:12,610 --> 00:26:17,610
ุชุจุฏุฃ within half an hour of lens insertion ุจุนุฏ

289
00:26:17,610 --> 00:26:22,540
ู†ุตู ุงู„ุณุงุนุฉ ุงู„ุฃูˆู„ู‰ ู…ู† ุงุฑุชุฏุงุก ุงู„ุนุฏุณุฉ and generally

290
00:26:22,540 --> 00:26:27,900
peaks within three hours ูˆุจุชูƒูˆู† ุงู„ู‚ู…ุฉ ู„ู‡ุง ุจุนุฏ ู‚ุฏูŠุดุŸ

291
00:26:27,900 --> 00:26:32,560
ุชู„ุช ุณุงุนุงุช in

292
00:26:32,560 --> 00:26:38,400
daily wear lenses typically ranges from one point

293
00:26:38,400 --> 00:26:43,100
five percent to five percent ุทุจุนู‹ุง ู‡ู†ุง ุงู„ู…ู‚ุตูˆุฏ ููŠู‡ุง

294
00:26:43,100 --> 00:26:46,720
ุงู„ู€ conventional daily wear ุนุฏุณุงุช ุงู„ู„ุจุณ ุงู„ูŠูˆู…ูŠ

295
00:26:46,720 --> 00:26:52,410
ุงู„ุชู‚ู„ูŠุฏูŠ ุฅุฐุง ูƒุงู†ุช ุงู„ู†ุณุจุฉ ู‡ุฐู‡ ู…ุง ุจูŠู† ูˆุงุญุฏ ูˆ ู†ุต ู„ุฎู…ุณุฉ

296
00:26:52,410 --> 00:26:58,150
ุจูŠูƒูˆู† normal ูˆู„ูƒู† ุจุฏูŠ ุฃุณุฃู„ ุณุคุงู„ ุฅู† ู‡ุฐู‡ ุงู„ู†ุณุจุฉ ุทูˆู„

297
00:26:58,150 --> 00:27:04,030
ุงู„ูŠูˆู… ูˆู„ุง ููŠ ูุชุฑุฉ ุฒู…ุงู†ูŠุฉ ู…ุนูŠู†ุฉุŸ ุทูˆู„ ุงู„ูŠูˆู… ุทูˆู„

298
00:27:04,030 --> 00:27:07,930
ุงู„ูŠูˆู… ู‡ุชุฎุชู„ู ูˆุจุชุงุนุฉ ุจุณ ู„ุงุฒู… ุชูƒูˆู† ุถู…ู† ุงู„ู€ range ู‡ุฐุง

299
00:27:07,930 --> 00:27:14,230
ูŠุนู†ูŠ ุญุชู‰ ู„ุณุงุนุงุช ุฒูŠ ู…ุง ูƒุงู† ุงู„ุดุบู„ ุฃู†ุง ุจู‚ูˆู„ ุจู…ุง ุฃู† ู‡ูŠ

300
00:27:14,230 --> 00:27:20,070
ู„ุจุณ ูŠุนู†ูŠ ู…ุฑุฉ ูˆุงุญุฏุฉ ูˆุฎู„ุงุต ุฅู†ู‘ู‡ ู„ุฃ ุนุงุฏูŠุŒ ุจุชุถู…ู† ููŠ

301
00:27:20,070 --> 00:27:25,770
ูุชุฑุฉ ู…ุนูŠู†ุฉุŒ ู„ุฃ ู…ุด ูƒู„ ุงู„ูŠูˆู…ุŒ ู„ุฅู†ู‡ ู„ู…ุง ุจูŠุณุฃู„ ุตุจุงุญู‹ุง

302
00:27:25,770 --> 00:27:28,570
ุฃุญูŠุงู†ู‹ุง ุฅู†ู‡ู… ุจุชูƒูˆู† ุนู†ุฏู‡ ุฃุนู„ู‰ ู…ู† ุงู„ู†ุณุจุฉ ู‡ุฐู‡ุŒ ู‡ูˆ

303
00:27:28,570 --> 00:27:31,050
ุทุจูŠุนูŠ ุงู„ู€ thickness ุจูŠูƒูˆู† ุฃูƒุซุฑุŒ ูŠุนู†ูŠ ุงู„ู€ school has

304
00:27:31,050 --> 00:27:39,750
to .. another answer ุงู„ู†ุณุจุฉ ู‡ุฐู‡ ุจุชูƒูˆู† ุทุจูŠุนูŠุฉ ุฅุฐุง

305
00:27:39,750 --> 00:27:44,920
ูƒุงู†ุช ุทูˆู„ ุงู„ูŠูˆู… ู„ุฃู† ุฃู†ุชูˆ ุดุงูŠููŠู† ู…ุง ููŠ fixed number

306
00:27:44,920 --> 00:27:50,440
ููŠ ุฃูŠู‡ุŸ ุงู„ู„ูŠ ู‡ูˆ range ูŠุนู†ูŠ ู…ู† ูˆุงุญุฏ ูˆ ู†ุต ู„ุฎู…ุณุฉ ูŠุนู†ูŠ

307
00:27:50,440 --> 00:27:55,260
ู…ู…ูƒู† ุฃูˆู„ ู…ุง ูŠุตุญู‰ ู…ู† ุงู„ู†ูˆู… ุชูƒูˆู† ุฎู…ุณุฉ ุจุนุฏ ุฐู„ูƒ ุจุชู‚ู„

308
00:27:55,260 --> 00:27:58,900
ูƒู„ ู…ุง ุงู„ุฅู†ุณุงู† ุฑุงุญ ุนู„ู‰ ุงู„ุนู…ู„ ุฃูˆ ุนู„ู‰ ุงู„ุฏุฑุงุณุฉ ุจุชู‚ู„

309
00:27:58,900 --> 00:28:02,380
ู‡ุฐู‡ ุงู„ู†ุณุจุฉ ูˆู„ูƒู† ู‡ุฐู‡ ุงู„ู†ุณุจุฉ ููŠ ุงู„ู€ conventional

310
00:28:02,380 --> 00:28:07,260
daily wear ุฅุฐุง ุฒุงุฏุช ุนู† ุฎู…ุณุฉ ุฎู„ุงู„ ุงู„ูŠูˆู… ู‡ู†ุง ุจูŠูƒูˆู†

311
00:28:07,260 --> 00:28:09,400
ููŠ ุฃูŠู‡ุŸ ุฃู…ุฑ ุงู„ู„ูŠ ู‡ูˆ pathology

312
00:28:12,530 --> 00:28:16,130
ุทุจุนู‹ุง ููŠ ุญุงู„ุฉ ุนุฏุณุงุช ุงู„ู€ extended wear ุงู„ู„ูŠ ุจุชู…

313
00:28:16,130 --> 00:28:20,170
ุงุฑุชุฏุงุฆู‡ุง ู„ู…ุฏุฉ ุฃุณุจูˆุน ูƒุงู…ู„ ูˆ ุจูŠู†ุงู… ููŠู‡ุง ุงู„ู†ุณุจุฉ ู‡ุฐู‡

314
00:28:20,170 --> 00:28:27,670
ุฃูŠุถู‹ุง ู‡ุชุฒูŠุฏ ู‡ุชูƒูˆู† ุชู‚ุฑูŠุจู‹ุง ู…ู† 10% ู„ 12% ูˆุฃูŠุถู‹ุง ุฅุฐุง

315
00:28:27,670 --> 00:28:33,330
ูƒุงู†ุช ุงู„ู†ุณุจุฉ ู‡ุฐู‡ ู…ู† 10% ู„ 12% ุจูŠูƒูˆู† ุงู„ุฃู…ุฑ ุทุจูŠุนูŠ

316
00:28:33,330 --> 00:28:38,550
ุฅุฐุง ุฒุงุฏุช ุนู† ุฐู„ูƒ ุจูŠูƒูˆู† ููŠ ู‡ู†ุงูƒ ูŠุนู†ูŠ ุฏุงุนูŠ ู„ู„ุชุฏุฎู„ ู…ู†

317
00:28:38,550 --> 00:28:41,730
ู‚ุจู„ ุงู„ู€ practitioner ุฃูˆ ุงู„ู€ optometrist 

318
00:28:45,100 --> 00:28:51,120
ู…ู‚ุงุฑู†ุฉ ุงู„ุซู‚ูŠู„ุฉ ุงู„ู‡ูŠุจูˆุชูˆู†ูŠุฉ ูŠู…ูƒู† ุชุฃุซูŠุฑู‡ุง ุฃูŠุถู‹ุง ู…ู†

319
00:28:51,120 --> 00:28:57,500
ู†ูˆุน ู…ู† ุงู„ู‡ูŠุจูˆุชูˆู†ูŠุฉ ุฃูˆ ู…ู† ู†ูˆุน ู…ู† ุงู„ู‡ูŠุจูˆุชูˆู†ูŠุฉ ุฃูˆ ู…ู† 

320
00:28:57,500 --> 00:28:59,180
ู†ูˆุน ู…ู† ุงู„ู‡ูŠุจูˆุชูˆู†ูŠุฉ ุฃูˆ ู…ู† ู†ูˆุน ู…ู† ุงู„ู‡ูŠุจูˆุชูˆู†ูŠุฉ ุฃูˆ ู…ู†

321
00:29:02,530 --> 00:29:07,310
ุฏุงูŠู…ู‹ุง ููŠู‡ ู‡ู†ุงูƒ ุนุงู…ู„ูŠู† ุฃุณุงุณูŠูŠู† ุจุฃุซุฑู‡ ุนู„ู‰ ู…ูŠู†ุŸ ุนู„ู‰

322
00:29:07,310 --> 00:29:12,650
ุณู…ุงูƒุฉ ุงู„ู‚ุฑู†ูŠุฉ ุงู„ุนุงู…ู„ ุงู„ุฃูˆู„ ู‡ูˆ ุชุฃุซูŠุฑ ุงู„ู€ reflex

323
00:29:12,650 --> 00:29:16,770
hypotonic tearing ุทุจุนู‹ุง ุฅุญู†ุง ุนุงุฑููŠู† ุงู„ู€ basic tear

324
00:29:16,770 --> 00:29:21,970
secretion ู…ู† ุฃู†ูˆุงุนู‡ ุงู„ู€ reflex tearing ุตุญูŠุญุŸ ู…ุนู†ุงู‡ุง

325
00:29:21,970 --> 00:29:27,360
hypotonic ุฅูŠุด ู…ุนู†ุงู‡ุงุŸ ุฃู†ู‘ู‡ ุจูŠูƒูˆู† ู‡ู†ุงูƒ ุถุบุท ุงุณู…ูˆุฒูŠ

326
00:29:27,360 --> 00:29:32,720
ูŠุนู†ูŠ ุฏุงูŠู…ู‹ุง ุงู„ู€ concentration ุงู„ุชุฑูƒูŠุฒ ู„ู€ ุงู„ู€ stroma

327
00:29:32,720 --> 00:29:38,580
ู‡ูŠูƒูˆู† ู…ุฎุชู„ู ุนู† ู…ูŠู†ุŸ ุงู„ุฃุฌุฒุงุก ุงู„ุฃุฎุฑู‰ ููŠ ุงู„ู‚ุฑู†ูŠุฉ ูƒูŠู

328
00:29:38,580 --> 00:29:47,340
ูŠุนู†ูŠุŸ ู†ูุชุฑุถ ู…ุซู„ู‹ุง ุนู†ุฏู†ุง ุงู„ู€ stroma ูƒุงู† ููŠู‡ุง ุงู„ู€

329
00:29:47,340 --> 00:29:53,200
concentration ุนุดุฑุฉ

330
00:29:53,200 --> 00:30:00,550
ููŠ ุงู„ู…ูŠุฉ ุงู„ุงุจูŠุซูŠู„ูŠุงู… ูˆุงู„ุฃุฌุฒุงุก ุงู„ุชุงู†ูŠุฉ ู…ู† ุงู„ู€ cornea

331
00:30:00,550 --> 00:30:07,310
ูƒุงู†ุช ุชู„ุงุชุฉ ููŠ ุงู„ู…ูŠุฉ ุฃูˆ ุฃุฑุจุนุฉ ููŠ ุงู„ู…ูŠุฉ ูŠุนู†ูŠ ุฃู‚ู„ ู‡ุฐุง

332
00:30:07,310 --> 00:30:12,030
ุจูŠุนู…ู„ ุฃูŠู‡ุŸ tearing hypotonic ูŠุนู†ูŠ ุจูŠูƒูˆู† ุงู„ุชู…ุฑูƒุฒ ุฃูˆ

333
00:30:12,030 --> 00:30:17,010
ุงู„ุชุฑูƒูŠุฒ ููŠ ุงู„ู€ stroma ุฃุนู„ู‰ ู…ู† ุจุงู‚ูŠ ุงู„ุฃุฌุฒุงุก ูุจูŠุนู…ู„

334
00:30:17,010 --> 00:30:22,890
ุญุงุฌุฉ ุจู†ุณู…ูŠู‡ุง reflex hypotonic tearing ูˆุงุถุญุฉุŸ

335
00:30:24,290 --> 00:30:29,150
or by a physical thinning of the stroma ุงู„ู€ long

336
00:30:29,150 --> 00:30:35,950
term wear ุงู„ุขู† ุจุนุถ ุงู„ู†ุงุณ ุจูŠูƒูˆู† ู…ุฎุตุต ุฅู„ู‡ ุฅู†ู‡ ูŠู„ุจุณ

337
00:30:35,950 --> 00:30:41,450
ุงู„ุนุฏุณุฉ ุงู„ู„ุงุตู‚ุฉ ู„ู…ุฏุฉ ุนุดุฑ ุณุงุนุงุช ุจุฑูˆุญ ุจู„ุจุณู‡ุง ุฎู…ุณ ุนุดุฑ

338
00:30:41,450 --> 00:30:47,030
ุณุงุนุงุช ุฅุฐุง ุตุงุฑ ุนู†ุฏู‡ ุฅูŠุดุŸ long term wear ู‡ุฐุง ุฅูŠุด ูƒู„ู‡

339
00:30:47,030 --> 00:30:51,690
ู‡ูŠุนู…ู„ thinning ู„ู„ุงุณุชุฑูˆู…ุฉุŒ ู‡ูŠู‚ู„ู„ ู…ู† ุณู…ุงูƒุฉ ู…ูŠู†ุŸ

340
00:30:51,690 --> 00:30:53,770
ุงู„ุงุณุชุฑูˆู…ุฉ ู…ุน ุงู„ูˆู‚ุช

341
00:30:58,120 --> 00:31:03,300
Also there is marked individual variability in the

342
00:31:03,300 --> 00:31:08,740
degree of corneal swelling response ุจุนุถ ุงู„ุฃุญูŠุงู†

343
00:31:08,740 --> 00:31:14,460
ุจูŠูƒูˆู† ู‡ุฐุง ุงู„ูƒู„ุงู… ุบูŠุฑ ู…ุนู…ู… ุนู„ู‰ ูƒู„ ุงู„ู†ุงุณุŒ ูƒูŠู ูŠุนู†ูŠุŸ

344
00:31:14,860 --> 00:31:20,140
ุงู„ุขู† ู…ุซู„ู‹ุง ู†ูˆุฑ ุงุฑุชุฏุช ุนุฏุณุฉ conventional daily wear

345
00:31:20,140 --> 00:31:24,600
ุงู„ู€ parameters ู…ุนูŠู† ู…ู† ุญูŠุซ ุงู„ู€ base curve ุงู„ู€ power

346
00:31:24,600 --> 00:31:29,880
ุงู„ู€ diameter ุงู„ู€ water content ุงู„ู€ thickness ูƒู„ ู‡ุฐุง

347
00:31:29,880 --> 00:31:35,080
ู…ุดุงุจู‡ ู„ู…ูŠู†ุŸ ู„ุนุฏุณุฉ ุงุฑุชุฏุชู‡ุง ุฎุฏูŠุฌุฉ ููŠ ู†ูุณ ุฅูŠุด ุงู„ู€

348
00:31:35,080 --> 00:31:39,940
parameters ุงู„ุขู† ู‚ุฏ ูŠูƒูˆู† ุนู†ุฏู‡ุง ุงู„ู€ stroma ุงู„ู‚ุฏูŠู…ุฉ

349
00:31:39,940 --> 00:31:45,660
ู…ุฎุชู„ูุฉ ุนู† ู…ูŠู†ุŸ ุนู† ุงู„ู„ูŠ ู‡ูˆ ุฎุฏูŠุฌุฉ ููƒู„ ุดุฎุต ุจูŠูƒูˆู† ู…ุฎุชู„ู

350
00:31:45,660 --> 00:31:51,140
ุนู† ุงู„ุขุฎุฑ ููŠ ุงุณุชุฌุงุจุชู‡ ู„ู…ูŠู†ุŸ ู„ู„ุชุฃุซูŠุฑุงุช ุงู„ุฎุงุฑุฌูŠุฉ ุงู„ู„ูŠ

351
00:31:51,140 --> 00:31:56,200
ุจุชุทุฑู‚ ู…ู† ุฎู„ุงู„ ุงู„ุนุฏุณุฉ ุงู„ู„ุงุตู‚ุฉ ู„ุฐู„ูƒ ุฅุญู†ุง ู‚ู„ู†ุง there

352
00:31:56,200 --> 00:32:00,220
is marked individual ูŠุนู†ูŠ ู‡ูŠูƒูˆู† ู‡ุฐุง ุงู„ุฃู…ุฑ ูุฑุฏูŠ

353
00:32:00,220 --> 00:32:06,360
variability ุงุฎุชู„ุงู ููŠ ุฏุฑุฌุฉ ุฃูŠู‡ุŸ ุงู†ุชูุงุฎ ุฃูˆ ุงู„ุงุณุชุฌุงุจุฉ

354
00:32:06,360 --> 00:32:12,820
ู„ุงู†ุชูุงุฎ ู…ู† ุงู„ู€ cornea corneal

355
00:32:12,820 --> 00:32:17,580
distortion ุทุจุนู‹ุง ุงู„ู€ corneal distortion ุฏุงูŠู…ู‹ุง ุจุชูƒูˆู†

356
00:32:17,580 --> 00:32:23,330
ู…ุตุงุญุจุฉ ู„ู…ูŠู†ุŸ ู„ู„ู€ RGP ุงู„ู€ RGP ุฃูˆ ุงู„ู€ hard contact

357
00:32:23,330 --> 00:32:27,910
lenses ู…ู† ุงู„ู€ advantages ู„ู„ู€ soft contact lens ุฃู†ู‘ู‡

358
00:32:27,910 --> 00:32:32,990
ุจูŠูƒูˆู† ุบูŠุฑ ุดุงุฆุน ุฃูˆ very rarely ู†ุชูŠุฌุฉ ุฃู†ู‘ู‡ ุฅูŠุด ุงู„ู€

359
00:32:32,990 --> 00:32:37,010
soft contact lens ุฏุงูŠู…ู‹ุง ุจูŠุณุจุจ minimal central

360
00:32:37,010 --> 00:32:38,630
corneal distortion

361
00:32:41,500 --> 00:32:46,780
ุฃุณุจุงุจู‡ุง number one a result of poor RGP lens

362
00:32:46,780 --> 00:32:52,020
fitting ูƒุงู†ุช ุงู„ุนุฏุณุฉ ู…ุซู„ู‹ุง tight ุฃูˆ ูƒุงู†ุช ุงู„ุนุฏุณุฉ flat

363
00:32:52,020 --> 00:32:57,400
ู…ู…ูƒู† ูŠุณุจุจ ุนู†ุฏ ุงู„ู…ุฑูŠุถ corneal distortion or wear of

364
00:32:57,400 --> 00:33:02,900
low Dk ุนู„ู‰ t ุฃูˆ ุฏุงูŠู…ู‹ุง ุจู„ุจุณ ุนุฏุณุงุช ููŠู‡ุง Dk ุนู„ู‰ t

365
00:33:02,900 --> 00:33:08,460
very low ุฅูŠุด ู…ุนู†ุงู‡ุงุŸ ูŠุนู†ูŠ ุญูŠุงุชู‡ุง ู…ุฏุฉ ุญูŠุงุชู‡ุง ุทูˆูŠู„ุฉ

366
00:33:08,460 --> 00:33:09,180
ุงู„ุนุฏุณุฉ

367
00:33:19,520 --> 00:33:25,300
ุฃูˆ ุจู„ุจุณ ุนุฏุณุงุช ู„ุงุตู‚ุฉ ูู‚ุท ู…ุตู†ูˆุนุฉ ู…ู† ู…ุงุฏุฉ ุงู„ู€

368
00:33:25,300 --> 00:33:28,600
polymethyl methacrylate ุงู„ู„ูŠ ู‡ูŠ ุชุนุชุจุฑ ุงู„ุฌูŠู„ ุงู„ุฃูˆู„

369
00:33:28,600 --> 00:33:32,460
ู…ู† ุงู„ุนุฏุณุงุช ุทุจุนู‹ุง ูˆุฃูƒูŠุฏ ู‡ุฐุง ู‡ูŠุณุจุจ ุฅูŠุดุŸ Cornial

370
00:33:32,460 --> 00:33:36,760
distortion ู„ุฐู„ูƒ ุงู„ู€ researchers ุงู„ุจุงุญุซูŠู† ุนู…ู„ูˆุง ุนู„ู‰

371
00:33:36,760 --> 00:33:40,740
ุฅุถุงูุฉ ู…ูŠู†ุŸ ู…ุงุฏุฉ ุงู„ู€ silicon ุนุดุงู† ุชุฒูˆุฏ ู…ู† ุงู„ู€

372
00:33:40,740 --> 00:33:44,920
wetability ุงู„ู…ุชุงู†ุฉ ููŠ ุงู„ุฌูŠู„ ุงู„ุซุงู†ูŠ ู…ู† ู‡ุฐุง ุงู„ู†ูˆุน ู…ู†

373
00:33:44,920 --> 00:33:50,920
ุงู„ุนุฏุณุงุช is an uncommon complication of hydrogel

374
00:33:50,920 --> 00:33:56,220
lens wear ุทุจุนู‹ุง ู‡ูŠ ุบูŠุฑ ู…ุง ู‡ุชูƒูˆู† ุดุงุฆุนุฉ ู…ุน ุนุฏุณุงุช ุฃูŠู‡ุŸ

375
00:33:56,220 --> 00:33:59,040
ุงู„ู€ conventional daily wear soft contact lenses

376
00:33:59,040 --> 00:34:03,740
ุงู„ุณุจุจ ููŠ ุฐู„ูƒ minimal central corneal distortion

377
00:34:07,210 --> 00:34:13,250
Such distortion is known as spectacle flare or

378
00:34:13,250 --> 00:34:18,450
corneal warpage and is manifested as a change in

379
00:34:18,450 --> 00:34:22,890
the spectacle refraction and central corneal

380
00:34:22,890 --> 00:34:28,250
curvature ู‡ุฐุง ุงู„ู€ corneal distortion ุฎุทูˆุฑุชู‡ ุฃู†ู‘ู‡

381
00:34:28,250 --> 00:34:32,590
ุจูŠุนู…ู„ ุญุงุฌุฉ ุจู†ุณู…ูŠู‡ุง ุงู„ู€ spectacle flare ุดูˆ ู…ุนู†ุงู‡ุงุŸ

382
00:34:33,530 --> 00:34:37,450
ุฃู†ู‘ู‡ ู‡ูŠูƒูˆู† ููŠู‡ ุงุฎุชู„ุงู ู„ู„ุฑุคูŠุฉ ู…ุง ุจูŠู† ุงุฑุชุฏุงุก ุงู„ุนุฏุณุฉ

383
00:34:37,450 --> 00:34:42,310
ุงู„ู„ุงุตู‚ุฉ ูˆุงู„ู†ุถุงุฑุฉ ูˆุทุจุนู‹ุง ู‡ุฐุง ุจูŠุคุฏูŠ ู„ุฅูŠุดุŸ ู„ู„ู‚ุฑู†ูŠุฉ

384
00:34:42,310 --> 00:34:46,190
ุงู„ู‚ุฏูŠู…ุฉ ู„ุฃู†ู‘ู‡ ุฏุงูŠู…ู‹ุง ุงู„ู‚ุฑู†ูŠุฉ ุงู„ู‚ุฏูŠู…ุฉ ููŠ ุงู„ุนุฏุณุงุช ุงู„ู€

385
00:34:46,190 --> 00:34:51,630
hard contact lens ุฃูƒุซุฑ ู…ู† ุงู„ู€ soft contact lenses ูˆ

386
00:34:51,630 --> 00:34:55,830
ุฃูŠุถู‹ุง ุจูŠุนู…ู„ ุนู„ู‰ ุชุบูŠูŠุฑ ููŠ ุฅูŠุดุŸ ููŠ ุชุญุฏุจ ุงู„ู‚ุฑู†ูŠุฉ ุงู„ู€

387
00:34:55,830 --> 00:35:01,650
corneal curvature power ู†ุชูˆู‚ู ุฅู† ุดุงุก ุงู„ู„ู‡ ู„ู„ุงุณุชุฑุงุญุฉ

388
00:35:01,650 --> 00:35:05,790
ุงู„ุงุณุชุฑุงุญุฉ ููŠ ุงู„ู…ุญุงุถุฑุฉ ุงู„ู‚ุงุฏู…ุฉ ุจู†ูƒู…ู„ ุฅู† ุดุงุก ุงู„ู„ู‡